Abstract:
Poor nutrition during the first two years of life has long term consequences, but resourcepoor
households often do not have the means to access nutrient-dense and diverse diets. Pooled data
of 24-h dietary recalls (n = 3336) and 2019 retail food prices were analyzed to determine associations
of retail cost and energy cost (per 100 kcal) with diet quality indicators for diets of 6–24-monthold
South African children who were breastfed (BF-diet) and not breastfed (NBF-diet) during the
24-h recall period. Compared to the BF-diet, retail cost for the NBF-diet was three times higher for
age 6–11 months, and double for age 12–17 months. Higher retail cost and energy cost were both
associated with higher mean adequacy ratios and dietary diversity scores for BF and NBF diets, except
energy cost for the NBF-diet for age 6–11 months. Overall, inclusion of flesh foods, vitamin A-rich
fruits and vegetables, and other fruit and vegetables increased from the lowest to the highest retail
cost tertile. The higher cost of more nutritious diets highlights the importance of the affordability
of diets in interventions aimed at improving diet quality. Possible strategies include: identifying
the most-affordable foods within each food group, focusing on foods that provide multiple key
micronutrients, and the inclusion of locally available indigenous foods.
